Curie Brief
Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
News
A new corneal cross-linking treatment called Epioxa is off to a smoother insurance start than its predecessor. Ophthalmologist Dr. Kenneth Beckman reports that most patients are paying little to nothing out of pocket, and major insurers are covering both the procedure and drug codes. It's a notable contrast to the early days of epithelium-off cross-linking, which was plagued by denials and costly appeals.
A new oxygen-supplemented, epithelium-on corneal cross-linking treatment — Epioxa (Glaukos) — is showing early promise not just clinically, but on the reimbursement front too. Ophthalmologist Dr. Kenneth Beckman shares that in his first dozen-plus cases, both the procedure code (CPT 0402T) and the new permanent drug code (J2789, effective July 1) are being reliably paid by insurers — with no peer-to-peer meetings required yet. That's a meaningful improvement over the rocky early days of FDA-approved epithelium-off cross-linking, which was marked by insurance denials, underpayments, and frequent appeals.
To manage financial risk, Dr. Beckman's practice uses a specialty pharmacy model, which handles preauthorization, claims, and appeals — removing the burden of drug inventory from the practice. For patients without compatible insurance, third-party buy-and-bill options are being explored. Glaukos also offers patient support programs (EpioxaCareConnect) that have helped reduce out-of-pocket drug costs to zero for many commercially insured patients.
Key Takeaways:
Why it matters: Financial barriers have historically caused patients with keratoconus to delay or forgo cross-linking treatment. Epioxa's smoother reimbursement pathway could meaningfully improve access and help preserve vision for more patients sooner.
